Mylrea, Martina F. (2018) Design and evaluation of a novel professional identity development program for pharmacy students. PhD thesis, James Cook University.

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Abstract

Professionalism, which is integral to the practice of pharmacy, is evolving to include a recognition of the importance of the development of professional identity. What is lacking, however is the presence of a framework for understanding the formation of student professional identity and the selection of suitable pedagogical approaches to facilitate such development. Educators are under increasing pressure to produce work-ready graduates, which involves the development of student professionalism. Current competency-based approaches focus on promoting student professional attitudes, values and behaviours. While these competencies are important to professional practice, they fail to adequately capture the complexity and richness of the professional role. A greater understanding of the mechanism of identity development, paired with pedagogies, which support identity formation, would better enable educators to adequately prepare students for professional practice. Professional identity is formed on two levels; the individual or psychological level and the collective level, also known as socialisation. The aim of this study was to develop a Professional Identity Program (PIP), designed to facilitate student professional identity formation, targeting the psychological development of the individual student. This study utilised the theoretical tenets of Self-Determination Theory (SDT), a psychological theory of human motivation and identity development, as a basis for the design of the program. SDT states that satisfaction of the three human basic psychological needs; competence, relatedness and autonomy, results in increased motivation (autonomy) and identity development. The PIP featured autonomy-supportive teaching in a longitudinal, early intervention, theory-based approach to professional development for pharmacy students.

Methods

Design: In line with the central tenets of SDT, the PIP was designed to support student competence, relatedness and autonomy, with a view to enhancing student motivation and eliciting identity development. Recognised pedagogical strategies for providing such support were employed throughout the 2 year program. Early intervention was a feature of this program, providing students with the opportunity to consider professionalism and professional identity development by participating in active discussions with practicing pharmacists and other students, in their first year of study. Emotional intelligence training was included in the program for its link to professional identity development. In addition approaches previously proven to enhance professional development such as reflective activity, role models and authentic practice-related activity were also incorporated into the program.

Delivery: The PIP was integrated into the existing curricular structure, in each semester for the first two years of the BPharm. Sessions were delivered together with a practicing pharmacist, offering the students an opportunity to interact with the profession, in the absence of workplace exposure. Autonomy-supportive teaching techniques underpinned the delivery of the program, and a variety of teaching styles were employed to promote student participation and engagement.

Evaluation: A previously validated professional identity measure, the McLeod Clarke Professional Identity Scale (MCPIS-9), was utilised as part of a mixed methods approach to the evaluation of the PIP. The Pharm-S, an instrument for measuring student motivation was adapted from an existing scale, modifying the context for pharmacy education. The Pharm-S was validated using recognised techniques and incorporated, alongside the MCPIS-9 and demographic questions to form the student survey. Students in two separate first year cohorts (2014 and 2015 intake) were surveyed at 0, 12 and 24 months. The 2014 cohort did not receive the PIP, whereas the 2015 cohort had the PIP integrated into their curriculum. The student survey scores were summarised as averages in the case of the MCPIS items, and a weighted scoring protocol, the Relative Autonomy Index (RAI) was used for the Pharm-S. To effectively explore inter and intra group differences, inferential statistical techniques, using non-parametric analysis, was undertaken.

An additional survey, using likert-response, was also administered to the 2015 students for the purposes of evaluating the content and delivery of the PIP. Data from this survey were analysed using basic descriptive statistical techniques.

Focus groups of first and fourth year students were also conducted to gain a more in-depth understanding of the student experience of professional development. Responses from the focus groups were audio recorded and transcribed. The written transcriptions were then analysed using an analytical framework identifying key concepts, which were subsequently organised into themes.

Results

The Pharm-S instrument proved to be suitable for use after successfully conducting face, content, test-retest, construct and convergent validation techniques. A positive correlation (r=0.64) between motivation scores and professional identity scores was also revealed.

Analysis of the systematic monitoring of student motivation during the PIP, using the Pharm- S, showed a statistically significant increase in their motivation (autonomy) after 2 years participation in the program (U=421, Z=-2.5, p=0.012). Comparing student scores from those who received the PIP with student scores who did not receive the PIP, also revealed a statistically significant increase in motivation (autonomy) scores after two years in the program (Z=-2.3, p=0.020). Autonomy-supportive teaching has previously been reported to increase student autonomy through its student-centred focus1 and by increasing motivation to learn.²,³ Observed increases in motivation (autonomy) and a demonstrated link between Pharm-S and MCPIS-9 scores, provided evidence of professional identity formation when support is provided for student competence, relatedness and autonomy. This reflects the theoretical basis of SDT which states that the satisfaction of the three human basic psychological needs, lays a necessary foundation for identity development.⁴

The PIP was positively received by students with 100% stating that they gained a greater understanding of the importance of professionalism and 84% reporting that it improved their sense of professional identity (n=44, 88% response rate, M=18, F=26), mean age=20 yrs, SD=4.2). Student (first and fourth year) perceptions of their professional development revealed three major influencing factors; pharmacist-educators, curriculum and placement. Differences however were noted between groups, however, with the first years prioritising pharmacist educators and the fourth years, placement.

Conclusion

This study builds on and contributes to work in professional education by demonstrating the impact of an early intervention, theory-based, professional identity program. It is the first of its kind to apply the tenets of a psychological theory on motivation and to feature pedagogies that facilitate motivation and identity development in pharmacy students. Adopting autonomy-supportive teaching, a student-centred approach, increases their motivation and autonomy, this being linked with more effective patient-centred care and better patient health outcomes.

References

1. Ten Cate TJ, Kusurkar RA, Williams GC. How self-determination theory can assist our understanding of the teaching and learning processes in medical education. AMEE guide No. 59. Med Teach. 2011;33(12):961-973.

2. Orsini C, Evans P, Jerez O. How to encourage intrinsic motivation in the clinical teaching environment?: a systematic review from the self-determination theory. J Educ Eval Health Prof. 2015;12(8).

3. Niemiec CP, Ryan RM. Autonomy, competence, and relatedness in the classroom: Applying self-determination theory to educational practice. Theory and Research in Education. 2009;7(2):133-144.

4. Luyckx K, Vansteenkiste M, Goossens L, Duriez B. Basic need satisfaction and identity formation: Bridging self-determination theory and process-oriented identity research. J Couns Psychol. 2009;56(2):276-288.

Item ID:	56156
Item Type:	Thesis (PhD)
Keywords:	health professionals, motivation pharmacy education, professional identity, professionalisation, self-determination theory, pharmacy students, student motivation
Related URLs:	https://researchonline.jcu.edu.au/48819/ https://researchonline.jcu.edu.au/51602/
Copyright Information:	Copyright © 2018 Martina F. Mylrea
Additional Information:	For this thesis, Martina Mylrea received the Dean's Award for Excellence 2019. Publications arising from this thesis are available from the Related URLs field. The publications are: Chapter 3: Mylrea, Martina F., Sen Gupta, Tarun, and Glass, Beverley D. (2017) Developing professional identity in undergraduate pharmacy students: a role for self-determination theory. Pharmacy, 5 (2). Chapter 5: Mylrea, Martina F., Sen Gupta, Tarun, and Glass, Beverley D. (2017) Validation of a motivation survey tool for pharmacy students: exploring a link to professional identity development. Currents in Pharmacy Teaching and Learning, 9 (5). pp. 763-769.
Date Deposited:	20 Nov 2018 02:39
FoR Codes:	11 MEDICAL AND HEALTH SCIENCES > 1115 Pharmacology and Pharmaceutical Sciences > 111503 Clinical Pharmacy and Pharmacy Practice @ 34% 13 EDUCATION > 1302 Curriculum and Pedagogy > 130202 Curriculum and Pedagogy Theory and Development @ 33% 13 EDUCATION > 1302 Curriculum and Pedagogy > 130209 Medicine, Nursing and Health Curriculum and Pedagogy @ 33%
SEO Codes:	93 EDUCATION AND TRAINING > 9305 Education and Training Systems > 930501 Education and Training Systems Policies and Development @ 33% 93 EDUCATION AND TRAINING > 9302 Teaching and Instruction > 930201 Pedagogy @ 34% 93 EDUCATION AND TRAINING > 9303 Curriculum > 930302 Syllabus and Curriculum Development @ 33%
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